Lichtenstein Thorsten, Sprenger Alina, Weiss Kilian, Slebocki Karin, Cervantes Barbara, Karampinos Dimitrios, Maintz David, Fink Gereon R, Henning Tobias D, Lehmann Helmar C
Institute of Diagnostic and Interventional Radiology University Hospital of Cologne Cologne Germany.
Department of Neurology University Hospital of Cologne Cologne Germany.
Ann Clin Transl Neurol. 2017 Dec 4;5(1):19-28. doi: 10.1002/acn3.502. eCollection 2018 Jan.
To evaluate the utility of nerve diffusion tensor imaging (DTI), nerve cross-sectional area, and muscle magnetic resonance imaging (MRI) multiecho Dixon for assessing proximal nerve injury in chronic inflammatory demyelinating polyneuropathy (CIDP).
In this prospective observational cohort study, 11 patients with CIDP and 11 healthy controls underwent a multiparametric MRI protocol with DTI of the sciatic nerve and assessment of muscle proton-density fat fraction of the biceps femoris and the quadriceps femoris muscles by multiecho Dixon MRI. Patients were longitudinally evaluated by MRI, clinical examination, and nerve conduction studies at baseline and after 6 months.
In sciatic nerves of CIDP patients, mean cross-sectional area was significantly higher and fractional anisotropy value was significantly lower, compared to controls. In contrast, muscle proton-density fat fraction was significantly higher in thigh muscles of patients with CIDP, compared to controls. MRI parameters showed high reproducibility at baseline and 6 months.
Advanced MRI parameters demonstrate subclinical proximal nerve damage and intramuscular fat accumulation in CIDP. Data suggest DTI and multiecho Dixon MRI might be useful in estimating axonal damage and neurogenic muscle changes in CIDP.
评估神经扩散张量成像（DTI）、神经横截面积和肌肉磁共振成像（MRI）多回波狄克逊技术在评估慢性炎症性脱髓鞘性多发性神经病（CIDP）近端神经损伤中的作用。
在这项前瞻性观察性队列研究中，11例CIDP患者和11名健康对照者接受了多参数MRI检查，包括坐骨神经DTI以及通过多回波狄克逊MRI评估股二头肌和股四头肌的肌肉质子密度脂肪分数。在基线和6个月后，通过MRI、临床检查和神经传导研究对患者进行纵向评估。
与对照组相比，CIDP患者坐骨神经的平均横截面积显著更高，分数各向异性值显著更低。相反，与对照组相比，CIDP患者大腿肌肉的肌肉质子密度脂肪分数显著更高。MRI参数在基线和6个月时显示出高重现性。
先进的MRI参数显示CIDP存在亚临床近端神经损伤和肌肉内脂肪堆积。数据表明DTI和多回波狄克逊MRI可能有助于评估CIDP中的轴突损伤和神经源性肌肉变化。
